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Is the Migraine Patch Right for You?

Migraine headaches are a serious and disabling problem for many people. Fortunately, a variety of treatments—with a number of ways to take them—are now available.

What kinds of medications are available for migraine attacks?Many migraine medications are available. They can be taken many different ways—by mouth, through the nose, by inhalation, by injection, or through the skin.

Some commonly used medicines and their adminis­tration methods include:

Why are there so many ways of taking these medications?Apart from painful headaches, people with migraine often have other symptoms. For instance, many have a condition called gastroparesis, which slows down the gastrointestinal (GI) tract. This affects how fast drugs taken by mouth can enter the blood and start working. Many patients also have nausea with their migraines, and oral medicines can be difficult to take or may not stay down long enough to work.

For people who have trouble with oral medications, non­oral forms, like nose sprays, injections, or a skin patch (transdermal), are available. Each type of delivery system has its own set of pros and cons.

How do I choose a medication?The choice will depend on many factors, such as your type of migraine, other illnesses you may have, and your personal preferences. You and your doctor can talk about your needs and choose the best type of treatment for you.

PROS CONS

By mouth: regular oral tablets Convenient Gastroparesis, nausea, and vomiting during a migraine might make it hard to keep a pill down

By mouth: rapid-release tablets and dissolvable liquids

Starts working faster than regular tablets; convenient

Nausea and vomiting during a migraine might make it hard to keep a pill down

Nose spray Starts working quickly; avoids GI tract It can have a bitter taste and irritate the nose lining

Skin patch (transdermal) Starts working quickly; avoids GI tract; keeps steady levels of drug in blood

New/unfamiliar delivery system; may irritate the skin

Needle (injection) Starts working quickly; can be used with nausea and vomiting

Can be painful where the needle is injected; inconvenient

By breathing it in (inhalation) Starts working quickly; easy to use Can irritate the lungs and throat

Pros and Cons of Different Ways to Take Migraine Medicine

MEDICATION DELIVERY SYSTEM

Acetaminophen Oral

Ergots Oral, nose spray, injection, or inhalation

Nonsteroidal anti-inflammatories

Oral or injection

Triptans Oral, injection, nose spray, or skin patch (transdermal)

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What should I know about the transdermal migraine patch, the newest delivery system?The patch is a battery­powered device that sends medication through the skin. You use it once and then throw it away. It looks like a large band­aid that is worn on the upper arm or thigh for 4 hours. Because the patch is placed on the skin, the drug does not go into the GI tract. This fact is important for patients who have GI problems, such as gastroparesis or nausea, along with their migraines.

How does the patch work?The patch uses a low­level electrical current to send the medicine through the skin. The patch has two “wells”: one holds the migraine medicine, and the other holds a salt solution. The low­level electrical current makes the drug move across the skin and into the blood. (See the illustration below.)

Is the migraine patch right for me?The patch may be a good choice if you:

• Have not gotten migraine relief with pills

• Had a poor response to oral migraine drugs

• Have nausea and/or vomiting that gets worse when you take your current medicine

• Are afraid that drinking liquids to take oral medicine will make you vomit

• Often wait longer than you should to take your current medicine by mouth, nose, or needle

• Are worried about side effects with other medicines

• Are afraid of needle pain

You should not use the migraine patch if you have:

• Heart problems

• Had a stroke or have problems with your blood circulation

• Narrowing of the blood vessels in your legs, arms, stomach, or kidney

• Uncontrolled high blood pressure

• Severe liver problems

• An allergy to medications in the patch

Ask your doctor about any other possible reasons for using or not using the patch to help treat your migraines.

How do I apply the transdermal patch?The patch should be placed on your upper arm or thigh. You can ask your doctor for step­by­step instructions.

What side effects might I have with the patch?The most common side effects are pain, tingling,

+PositiveCharge

–Negative Charge

Battery/Power Controller

Transdermal Patch

Upper Arm

Blood VesselSkin Tissue

Electrically Charged

Drug Molecules

The Parts of a Transdermal Patch

© 2015 Med­IQ. All rights reserved.

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itching, warmth, discomfort, or a change in skin color where the patch is put on the skin.

Most people have some redness after taking the patch off, but this usually goes away in 24 hours. Tell your doctor if you have any side effects that bother you or do not go away.

Are there times when I should not wear the patch?Yes; do not wear the patch when:

• Bathing, showering, or swimming

• Having magnetic resonance imaging (MRI)

• Driving or using machinery (this is in case you have any dizziness, weakness, or drowsiness while using the patch)

How can I learn more about migraines and treatments?The following groups are good sources of information:

• American Headache and Migraine Association (https://ahma.memberclicks.net)

• American Headache Society (www.americanheadachesociety.org)

• American Headache Society® Committee for Headache Education (www.achenet.org)

• American Migraine Foundation (www.americanmigrainefoundation.org)

• National Headache Foundation (www.headaches.org)

This activity is supported by an educational grant from Teva Pharmaceuticals. © 2015 Med­IQ. All rights reserved.

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